Functional seizures are not less important than epilepsy

Asadi‐Pooya, Ali A.; Brigo, Francesco; Tolchin, Benjamin; Valente, Kette D.

doi:10.1016/j.ebr.2021.100495

Cited by 9 publications

(8 citation statements)

References 67 publications

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“…There is a high comorbidity of psychiatric diagnoses such as depression, anxiety, personality disorder or post-traumatic stress disorder (PTSD) amongst people with DS (Asadi-Pooya, et al, 2021;Bodde et al, 2009;D'Alessio et al, 2006). Nevertheless, the mental health care pathways for this population are underdeveloped and sometimes nonexistent within the UK.…”

Section: Introductionmentioning

confidence: 99%

Three sessions of intensive short-term dynamic psychotherapy (ISTDP) for patients with dissociative seizures: a pilot study

Castillo

Beton

Coman

et al. 2022

Psychoanalytic Psychotherapy

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Intensive Short Term Psychodynamic Therapy (ISTDP) has demonstrated promising evidence for the treatment of several Functional Neurological Disorders (FND) including dissociative seizures. However, its implementation in secondary mental health and specialist services within the English National Health Service (NHS) is scarce. The aim of this pilot study was to explore the estimates of the therapeutic effects of a 3-session course of this treatment as well as establish safety and acceptability for a complex patient group. Method: The study followed a mixed methods case series design and recruited 18 patients from secondary adult mental health care and specialist neurology services. Participants completed self-report outcome measures at the start, at the end and 1-month following the completion of therapy. Three open ended questions examined their therapy experiences qualitatively and these were analysed through thematic analysis. Results: All participants who started the treatment (N=17) completed the intervention and attendance rates were very high (95%). No serious adverse effects were observed, and the CORE-OM and BSI showed improvements both at the end of the treatment and at follow-up. Healthcare utilisation was also reduced including acute medications, A&E attendances, and crisis line usage. Conclusions: The results provide preliminary support for the safe use of ISTDP in this complex group of participants but further evidence from controlled and randomized studies is warranted.

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Section: Introductionmentioning

confidence: 99%

Three sessions of intensive short-term dynamic psychotherapy (ISTDP) for patients with dissociative seizures: a pilot study

Castillo

Beton

Coman

et al. 2022

Psychoanalytic Psychotherapy

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“…Functional (psychogenic) seizures are typically characterized by sudden and paroxysmal clinical events that semiologically may resemble epileptic seizures but that are not due to underlying epileptic activity; ictal electroencephalography (EEG) does not show any abnormal discharges [ 11 , 12 ]. “Functional seizures” are commonly encountered in neurology and epilepsy clinics around the world.…”

Section: Introductionmentioning

confidence: 99%

“…A systematic review and an analytical study estimated that the incidence of functional seizures was 3.1 (95% Confidence Interval CI: 1.1–5.1) per 100,000 population per year, and the prevalence rate of functional seizures in 2019 was 108.5 (95% CI: 39.2–177.8) per 100,000 population, in the USA [ 13 ]. Patients with functional seizures are at higher risk of having psychiatric comorbidities compared with the general population; this is comparable with patients with epilepsy [ 11 ]. In addition, functional seizures often have crippling effects on patients’ lives.…”

Section: Introductionmentioning

confidence: 99%

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Genetics of Functional Seizures; A Scoping Systematic Review

Asadi-Pooya,

Hallett,

Mirzaei Damabi

et al. 2023

Genes

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Background: Evidence on the genetics of functional seizures is scarce, and the purpose of the current scoping systematic review is to examine the existing evidence and propose how to advance the field. Methods: Web of science and MEDLINE were searched, from their initiation until May 2023. The following key words were used: functional neurological disorder(s), psychogenic neurological disorder(s), functional movement disorder(s), psychogenic movement disorder(s), functional seizures(s), psychogenic seizure(s), nonepileptic seizure(s), dissociative seizure(s), or psychogenic nonepileptic seizure(s), AND, gene, genetic(s), polymorphism, genome, epigenetics, copy number variant, copy number variation(s), whole exome sequencing, or next-generation sequencing. Results: We identified three original studies. In one study, the authors observed that six (5.9%) patients with functional seizures carried pathogenic/likely pathogenic variants. In another study, the authors observed that, in functional seizures, there was a significant correlation with genes that are over-represented in adrenergic, serotonergic, oxytocin, opioid, and GABA receptor signaling pathways. In the third study, the authors observed that patients with functional seizures, as well as patients with depression, had significantly different genotypes in FKBP5 single nucleotide polymorphisms compared with controls. Conclusion: Future genetic investigations of patients with functional seizures would increase our understanding of the pathophysiological and neurobiological problems underlying this common neuropsychological stress-associated condition.

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“…Finally, Dr. Asadi-Pooya and colleagues discuss the negative impacts of FS on many aspects of a person’s life [26] . Rather than focusing on the diagnosis or treatment, they take a novel approach of analyzing the negative consequences of FS (i.e., psychiatric comorbidities, social consequences, costs that are associated with the condition, cognitive impairment in patients with FS, the quality of life of the people with FS, and the increased risk of mortality that is associated with FS).…”

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confidence: 99%

Special issue on the intersection between functional seizures and other functional neurological disorders

Szaflarski

2022

Epilepsy & Behavior Reports

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Functional seizures are not less important than epilepsy

Cited by 9 publications

References 67 publications

Three sessions of intensive short-term dynamic psychotherapy (ISTDP) for patients with dissociative seizures: a pilot study

Three sessions of intensive short-term dynamic psychotherapy (ISTDP) for patients with dissociative seizures: a pilot study

Genetics of Functional Seizures; A Scoping Systematic Review

Special issue on the intersection between functional seizures and other functional neurological disorders

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